Document NdvQyQOZ00NJOB1GYyLRmwp8

FILE NAME: Z< DATE: DOC#: Z< DOCUMENT DESCRIPTION :ZZZZZ dZ&DZZZ Inhalation Toxicology, 2012; 24(2): 136-137 2012 Informa Healthcare USA, Inc. ISSN 0895-8378 print/ISSN 1091-7691 online 001: 10.3109/08958378.2011.643932 LETTER TO THE EDITOR Report of a recent Itbrake" through in the fiber burden-mesothelioma dialogue informa healthcare Marsh et al. concluded that "elevated lung levels oftremolite in the lungs of brake workers with elevated levels of amphiboles arose from concurrent exposures to commercial amphibole and chrysotile asbestos in occupational settings other than brake repair work:' Then, based on this "finding'; they conclude that "the weight of the scientific evidence does not support a role for occupational exposure to brake dust and other friction products in the development of mesothelioma" (Marsh, 2011). These statements are incorrect. The authors assume that occupational settings, where brake work is conducted, is free of amphibole exposure. This is not true. Commercial amphiboles were used to manufacture many friction-related components. Victor/Dana used crocidolite in gaskets until at least 1963, Borg Warner used crocidolite in transmission friction plates, Ford hygienists were aware of the use of amosite in brakes, Maremont used crocidolite during the Canadian asbestos strike, and Borg Warner admitted that it used crocidolite in brakes in one set of sworn interrogatories, and denied this in another set ofinterrogatory answers (Hickish, 1968; Borg-Warner, 1992 and 1996; Borg-Wamer,2006; Sherr, 2011; Egilman, 2011). Automobile mechanics who worked on brakes would typicallyworkwith these products. Thus, it is incorrect to assume that brake workers acquired elevated lung amphibole levels from anywhere but automobiles absent evidence that a patient had exposure to amphiboles at some other occupation. Working with automobiles can be the source of amphibole lung levels, and explains the results in this paper. The authors argue that chrysotile brakes can not be linked to mesothelioma because brake work never results in chrysotile lung burdens sufficient to cause mesothelioma. However, this is not true. Dr. Roggli found elevated levels of chrysotile in the lungs of two workers with pulmonary fibrosis whose only asbestos exposure was as a consequence ofthe work with asbestos brakes (Case 1, 1983 and Case 2, 1994) (Roggli, 2011) Dr. Roggll explained that he has failed to publish these cases because the patients did not suffer from mesothelioma (Roggli, 2011). However, this is irrelevant as the authors' theoryis based on the general proposition that working with brakes never results in elevated lung chrysotile levels. Any brake worker with elevated levels is a Black Swan case that disproves the authors' theory. For example, even absent lung fiber data, Dr. Roggli has opined that a particular brake worker's mesothelioma was idiopathic because he has not seen any brake workers who had above-background levels of asbestos in their lungs without a corresponding elevated level of commercial amphibole fibers (Roggli, 2011). Dr Roggli's methodology has been thoroughly critiqued elsewhere (Egilman,2009). In recent testimony, Dr. Roggli agreed with our interpretation of the importance of these results. He confirmed that mechanics' exposures can lead to levels of chrysotile and non-commercial amphiboles that cause increased fiber burden in their lung tissue, and he would have attributed causation to their exposures had they had mesothelioma (Roggli, 2011). Report of a recent "brake" through in the fiber burden-mesothelioma dialogue. Asbestos Total Commercial Patient bodies fibers amphiboles Chrysotile Tremolite Silicate Antho-phylite Case 1 0 10 0 Case 2 o 7 o 630 040 Actino-lite 0 2 Total uncoated fibers 42,800 21,800 Non-commercial asbestos fibers 8500 7000 Addressfor Correspondence: Dr. David Egilman, MD, MPH, 8 North Main Street, AttJeboro, MA 02703, USA. E-mail: degilman@egilman.com (Received 15 November 2011; accepted 21 November 2011) 136 R.OHTS ( ... Declaration of interest Dr. Egilman serves as a consultant in asbestos litigation at the request of asbestos manufacturing companies and injured people. David Egilman Department ofFamily Medicine Brown University Providence, RI, USA References Borg-Warner. Corporation's answers to Plaintiffs' master interrogatories and requests for production propounded to defendant. In reply: All asbestos-related personal injury or death cases filed or to be filed in Dallas County, Texas. June, 1992. Interrogatory response no. 6E and Borg-Warner Corporation's responses to Plaintiffs' master interrogatories and request for production to defendants. In reply: All asbestos-related filed or to be filed in Cameron County, Texas. January 27, 1996. Interrogatory response no. 6E. Letter to the Editor 137 Borg-Warner. Amended responses to interrogatories regarding BorgWarner'suseofcrocidoliteasbestosfibersinautomatictransmission parts. In reply: All asbestos litigation filed by SimmonsCooper, LLC, Plaintiffs - A.W. Chesterton, et al., defendants. In the Circuit Court, Third Judicial Circuit, Madison County, IL, Interrogatory response no. 2, March 31, 2006. Egilman D. 2009. Fiber types, asbestos potency, and environmental causation: a peer review ofpubJished work and legal and regulatory scientific testimony. Int J Occup Environ Health 15:202-228. Egilman. Available at: http://egilman.com/browse.php?display=list& dir=Asbestos/victor/. 2011 Hickish DE, Knight KL. Report 41168: 1968. Exposure to asbestos during the servicing of brakes of passenger cars. Marsh GM, YoukAO, Roggli VL. 2011. Asbestos fiber concentrations in the lungs of brake repair workers: commercial amphiboles levels are predictive of chrysotile levels. lnhal ToxicoI23:681-688. Roggli VL. Data count sheets, as discussed in Roggli VL. Deposition testimony, Keitha Durham vs General Electric et al., No. O9-CI09756, lefferson Circuit Court, Division Eleven October 24, 2011, pp 150-168, pp 179-180, p. 140, pp 180-181, andp.169. Sherr, 10nathan H. Deposition testimony as Corporate Designee of Maremont Corporation. Edward Neff, et al. vs American Honda Motor Company, Inc., et al. Case Number: 24-X-09-00018S. In the Circuit Court for Baltimore City, May 6, 2011. 20121nforma Healthcare USA, Inc. RiGHTS